(^78) CHAPTER 4 Substance Abuse
The plan of care for a patient who is a drug abuser will depend on the reason
for hospitalization. The physical response to drug use should be monitored and
any infections or disease states must be treated. The plan should also include
treatment for the abuse in a supportive and rehabilitative setting. This may
include counseling, psychotherapy sessions, and medications to overcome the
withdrawal symptoms.
Nursing implementation may focus on managing the patient’s acute intoxica-
tion and withdrawal and then monitoring the effectiveness of therapy to treat the
patient’s substance abuse problem.
The evaluation of the effectiveness of the treatment centers on how well the
patient is successfully detoxified and withdrawn from the drug and how well
the patient refrains from re-abusing the substance. It is important for nurses to
realize that overcoming a drug addiction is a long and sometimes lifetime task.
Patients may have many relapses along the way and the process can seem frus-
trating and hopeless. However, the nurse should remain non-judgmental and
objective when caring for substance abuse patients.
Summary
Substance abuse is one of the most widely misunderstood areas of pharmacol-
ogy and has led some patients to avoid narcotics and pain-relieving drugs for
fear of becoming addicted to the drug.
Substance abuse is the indiscriminant misuse of medication that results in a
physical and/or psychological dependence on the drug. A person is considered
addicted to a drug if over a six month period they develop dependence for the
drug, they experience withdrawal symptoms when the drug is no longer admin-
istered, and they require increased doses of the drug to experience the same ther-
apeutic effect.
An addicted person also has an uncontrollable urge to use the drug and self-
medication interferes with activities of daily life and continues despite the neg-
ative consequence of using the drug.
Drug abusers exhibit common behavioral patterns such as being unable to
maintain a normal routine, have poor hygiene, and strained family and social
relationships. They also have more legal problems than the average person. And
most importantly, they are frequently in denial that they have a problem.
Healthcare professionals are especially prone to drug abuse because drugs can
enhance performance during long shifts, drugs are easily accessible, and health-